This section is intended to introduce the reader to aspects of art that may be related to various aspects of the present disclosure described herein, which are described and/or claimed below. This discussion is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present disclosure described herein. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art.
Laparoscopic gastric sleeve surgery or vertical sleeve gastrectomy (VSG) involves removing or resecting approximately 70%-90% of a patient's stomach and leaving a tube or gastric sleeve. During VSG and other operations involving the esophagus and stomach, there is a need for placement of a bougie, which can be a slender, flexible, and cylindrical instrument for introduction into a tubular organ. The bougie can be placed down via the mouth and across the esophagus and/or stomach or small bowel. The purpose of this device is to act to dilate strictures and/or help delineate or function as a guide for the borders of the stomach and esophagus for resection of the stomach.
Conventional VSG procedures are generally highly invasive and can involve up to five (5) various incisions to successfully perform, which further can require up to six (6) weeks of recovery time, “inpatient” hospital stays, potential complications, and undesirable cosmetic scarring. Therefore, it is desirable for VSG patients to have a minimally invasive procedure that results in less pain, lower risk of complications, faster recovery, and few scars. One recent method of performing a minimally invasive procedure is known as Natural Orifice Transluminal Endoscopic Surgery (NOTES). The NOTES procedure for VSG, or a variation thereof, can include using various natural entrances to the abdominal cavity (i.e. rectum, vagina, etc.) to remove the resected stomach, thereby minimizing incisions. For example, in one study, Mintz et al. (Mintz Y, Horgan S, Savu M K, et al. Hybrid natural orifice translumenal surgery (NOTES) sleeve gastrectomy: a feasibility study using an animal model. Surg Endosc. 2008; 22:1798-802) performed a hybrid NOTES sleeve gastrectomy in a porcine model. In the study, they report their experience utilizing abdominal and rectal entry sites to perform the gastric sleeve procedure. In general, a 5 mm trocar and laparoscope was placed for pneumoperitoneum and visualization, and a 12 mm or 15 mm laparoscope placed transanally through the rectal wall of the model. Further, sutures via the anterior abdominal wall were placed into the stomach to aid retraction and exposure and a stapler was placed through the transrectal trocar to resect the stomach and the resected stomach extracted through transanally through the proctomy.
While advances have been made in achieving minimally invasive VSG procedures, there is still a need to further improve VSG procedures that involve minimal incisions, faster recovery, and less complication. Hence, what is needed is an apparatus and method of performing minimally invasive VSG procedures that reduce the number and size of the incisions, reduce operating costs, reduce the need for expensive surgical equipment, promote faster patient recovery, and further reduce complications associated with VSG surgery.